Maternal gestational weight gain of more than 0.9 kg per week is associated with an increased risk for cerebrovascular disease in adult offspring, but it is not linked to increased risk for all-cause mortality or CVD, according to recent findings.
In the study, researchers evaluated 3,781 original participants in the ACONF database, representing a population-based group of adults born between 1950 and 1956 in Aberdeen, Scotland. The database includes sociodemographic data about the children, along with anthropometric measurements taken between 1962 and 1964 as part of a school survey.
Questionnaires were used to acquire data on adult height, weight, socioeconomic status and self-reported history of diabetes. The researchers also consulted the Aberdeen Maternity and Neonatal Databank for pregnancy and delivery details of the mothers of children from ACONF, including age at delivery, height and prenatal weight. Scottish national records were used to obtain information about hospital admissions and deaths up to 2011. Maternal gestational weight gain was calculated by subtracting the first prenatal weight from the last recorded prenatal weight and dividing the difference by number of weeks between the two measurements.
Using maternal gestational weight gain as the exposure of interest, the researchers evaluated three outcomes in the offspring: all-cause mortality; any hospitalization for or death from CVD; and any hospitalization for or death from cerebrovascular disease. The researchers estimated HRs for CV events and death in the offspring based on maternal gestational weight gain. The analysis was adjusted for maternal and offspring confounding factors.
Causes of death
The researchers found that, among offspring, 103 (2.7%) had died, 169 (4.5%) had experienced at least one CV event and 73 (1.9%) had been hospitalized or died from cerebrovascular disease. The most prevalent causes of death were neoplasms (31.5%), circulatory system diseases (26%), digestive system disease (10%), metabolic disease (8.3%) and injury/trauma (6.2%).
Offspring who died were more likely to have mothers with a high prenatal BMI during pregnancy (mean, 23.64 kg/m2 vs. 22.85 kg/m2; P = .01). In adulthood, members of the cohort who died had a greater likelihood of belonging to a lower socioeconomic status group (P for trend = .03), being current smokers (54.4% vs. 24.3%; P < .01) and having diabetes (4.9% vs. 1.7%; P < .01).
Compared with offspring who did not have a CV event, those who did were more likely to be men (64.5% vs. 47%; P < .01), have lower socioeconomic status as adults (P for trend < .01), have a higher BMI (P for trend < .01) and report having diabetes (7.7% vs. 1.5%; P < .01).
Among the offspring who had cerebrovascular events, there was a greater likelihood of having mothers with a higher BMI in pregnancy (mean, 23.66 kg/m2 vs. 22.86 kg/m2; P = .03), according to the researchers. These individuals also were more likely as adults to be current smokers (57.5% vs. 24.5%; P < .01) and to have diabetes (8.2% vs. 1.6%; P < .01). Maternal weight gain of 1 kg per week or more was linked to elevated cerebrovascular event risk in the offspring (adjusted HR = 2.7; 95% CI, 1.19-6.12). No association was found between gestational weight gain and all-cause mortality or CV events in the offspring.
Adult lifestyle key
On univariate analysis, none of the outcomes of interest were associated with rate of maternal gestational weight gain, according to the researchers.
“For the first time, this large-scale cohort study was able to show that adult health and lifestyle factors, and not early life risk factors, played the most important role in determining [CV] mortality and morbidity,” the researchers wrote. “Modifying these risk factors (obesity, smoking and diabetes) would constitute effective preventive strategy, irrespective of early life risk factors.” – by Jennifer Byrne
Disclosure: The researchers report no relevant disclosures.